Anesthesia docs ‘unethical’ in threat to block surgeries

B.C. Health Minister Mike de Jong is accusing the B.C. Anesthesiologists’ Society of “unprofessional” and “unethical” behaviour by threatening to withdraw service next month, potentially disrupting thousands of scheduled surgeries.

The society, which de Jong said represents only a small number of anesthesiologists, repeated its ultimatum today that it will withdraw service for non-urgent elective surgeries starting April 2 unless it gets a seat at the bargaining table in talks between the province and the B.C. Medical Association (BCMA).

“I think it’s unfortunate any time any group of professionals, in this case doctors, threaten to hold patients hostage for a dispute that is at the end of the day about money,” de Jong said.

“The average full-time anesthetist today earns $340,000 a year, with very little in the way of overhead by virtue of the circumstances in which they practice.”

De Jong said his ministry has contacted the B.C. College of Physicians and Surgeons and asked it to remind individual anesthesiologists “what their professional and ethical obligations are” as well as the consequences for any service withdrawal.

The province will also work with all affected doctors to draw up a contingency plan to deal with any work stoppage.

The breakaway B.C. Anesthesiologists’ Society (BCAS) wants to negotiate separately from the BCMA, which bargains for all doctors in the province, including specialists.

De Jong said anesthesiologists have received BCMA-negotiated pay increases of 36.2 per cent since 2001 – more generous than the 22.3 per cent increase for the rest of the medical profession.

More than $13 million in new funding was added late in 2009 to improve the pay for obstetrical anesthesia.

De Jong said the BCAS supported the transfer and agreed there would be no withdrawal of obstetric anesthesia service and that any disputes over other services would be addressed through the Physician Master Agreement (PMA) that covers all specialties.

The threatened service withdrawal would violate previous agreements, according to the BCMA, which says also says the BCAS has encouraged its members to resign their BCMA memberships.

“We are still going to protect patients,” Orfaly said. “We will continue all emergency surgery. We will continue even non-emergency but cancer-related and cardiac surgery, all obstetric care and all care of pediatric patients 18 years and younger.”

Patients who can expect delays to their scheduled surgeries – if the impasse persists – include those awaiting non-emergency hip or knee replacements and cataract surgeries.

Orfaly said de Jong previously offered the BCAS a seat in binding talks with a conciliator but has reneged because neither the ministry nor the BCMA have actually allowed its society representatives to participate.

“If he agrees to deliver on his promise there will be no withdrawal of service,” Orfaly said. “If he chooses to break that promise, he’s choosing to escalate the confrontation.”

The BCAS first announced the planned April service withdrawal on Dec. 13.

Orfaly said anesthesiologists do not want to withdraw service but cannot accept a situation where they’re denied access to a process that could settle their issues.

He said the BCAS represents 80 to 90 per cent of the 400 practicing anesthesiologists in B.C., compared to less than 50 per cent who are BCMA members.

Orfaly said the province cannot override the majority and allow the BCMA to act as bargaining agent against their wishes.

The society has previously argued B.C. could open more operating rooms and reduce surgery waits if it was willing to increase the pay and supports needed to attract more anesthesiologists to the province.

Anesthesiologists claim pay rates here are half what they are in some other parts of Canada.

According to a statement issued by the BCMA, an extra $2.5 million was directed to obstetric anesthesia at three hospitals – Victoria General, Surrey Memorial and Royal Columbian – after the BCAS staged a media campaign to embarrass the government that focused on a stillbirth at Victoria General.

A third party review later found care was provided within time guidelines and anesthesia coverage was not a factor in the stillbirth.